| NPI | 1013294826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 2667) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002667) |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2017-10-16 |